Edit, Download, and Sign the Borough of Manhattan College Immunization Form

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How do I fill this out?

To fill out this form, start by providing your student information clearly. Next, ensure your healthcare provider completes the vaccination requirements section. Finally, review the entire form before submission to ensure accuracy.

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How to fill out the Borough of Manhattan College Immunization Form?

  1. 1

    Print the form and fill out your personal information.

  2. 2

    Have your healthcare provider complete the vaccination records.

  3. 3

    Sign the form where indicated.

  4. 4

    Attach any necessary lab results or medical exemption notes.

  5. 5

    Submit the completed form to Room N-303.

Who needs the Borough of Manhattan College Immunization Form?

  1. 1

    New students who need to comply with immunization regulations.

  2. 2

    Transferring students requiring proof from previous institutions.

  3. 3

    International students needing to meet US health requirements.

  4. 4

    Students re-admitting who have not submitted immunization records.

  5. 5

    Parents of minors who need to document immunizations for their children.

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What are the instructions for submitting this form?

Submit this form in person to the Student Health Services office located in Room N-303. You can also fax it to 212-220-2367. For any inquiries regarding this submission, please call 212-220-8256. Ensure to attach any necessary medical documentation as required.

What are the important dates for this form in 2024 and 2025?

Important dates for the submission of the immunization form include the start of each semester. Forms must be submitted at least three weeks prior to the semester start date. Check the BMCC academic calendar for specific deadlines.

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What is the purpose of this form?

The purpose of this form is to record proof of vaccination for Measles, Mumps, and Rubella, as mandated by New York State law. This documentation is crucial for student registration at Borough of Manhattan Community College. By ensuring all vaccinations are logged correctly, students can maintain their enrollment status and health compliance.

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Tell me about this form and its components and fields line-by-line.

The form consists of several key sections requiring detailed student information and vaccination records.
fields
  • 1. Student Information: Contains fields for the student's name, address, date of birth, and social security number.
  • 2. Vaccination Records: Details for MMR and meningococcal vaccinations provided by a healthcare provider.
  • 3. Acknowledgment of Meningococcal Meningitis Disease: A section for the student to acknowledge understanding of the disease and vaccination options.

What happens if I fail to submit this form?

Failing to submit this form may result in denial of course registration and inability to enroll in classes.

  • Registration Delays: Students may face delays in class registration if immunization records are not provided.
  • Health Compliance Issues: Non-compliance with vaccination laws could lead to health risks for unvaccinated students.
  • Administrative Penalties: Failure to comply may result in administrative penalties, including inability to attend classes.

How do I know when to use this form?

Use this form if you are a student at Borough of Manhattan Community College and need to provide proof of immunizations.
fields
  • 1. New Student Enrollment: First-time students must submit this form before attending classes.
  • 2. Transfer Students: Students moving from another institution need to provide their immunization records.
  • 3. International Students: Students coming from abroad to verify their immunization status as per state requirements.
  • 4. Returning Students: Students returning to the college after a break must also submit this form.
  • 5. For Minors: Parents/guardians of students under 18 years must fill this out to verify immunizations.

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